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Синдром поликистозных яичников: современный обзор
Синдром поликистозных яичников: современный обзор
Дубровина С.О. Синдром поликистозных яичников: современный обзор. Гинекология. 2016; 18 (5): 14–19.
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Аннотация
Поликистозный овариальный синдром – одно из наиболее часто встречающихся метаболических и репродуктивных нарушений у женщин репродуктивного возраста. Женщины, страдающие этим синдромом, имеют комплекс симптомов, ассоциированных с нарушением менструального цикла и гиперандрогенией, значительно ухудшающих качество жизни, повышающих риск ожирения, инсулинорезистентности, сахарного диабета типа 2, эндометриального рака и психологических нарушений. Данный обзор суммирует рекомендации по ведению синдрома поликистозных яичников, подчеркивает разные варианты терапии и скрининговые рекомендации, используемые в текущем времени.
Ключевые слова: синдром поликистозных яичников, гиперандрогения, бесплодие.
Key words: polycystic ovarian syndrome, hyperandrogeny, infertility.
Ключевые слова: синдром поликистозных яичников, гиперандрогения, бесплодие.
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Key words: polycystic ovarian syndrome, hyperandrogeny, infertility.
Полный текст
Список литературы
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30. Beckman Coulter. Access AMH Instructions for Use, September 2014. REFB13127.
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32. Piouka A, Farmakiotis D, Katsikis I et al. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab 2009; 296 (2): E238–43.
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34. Pellatt L, Rice S, Mason HD. Anti-Mullerian hormone and polycystic uovary syndrome: a mountain too high? Reproduction 2010; 139 (5): 825–33.
35. Pierre A, Peigné M, Grynberg M et al. Loss of LH-induced down-regulation of anti-Mullerian hormone receptor expression may contribute to anovulation in women with polycystic ovary syndrome. Hum Reprod 2013; 28 (3): 762–9.
36. Garg D, Tal R. The role of AMH in the pathophysiology of polycystic ovarian syndrome. Reprod Biomed Online 2016; 33 (1): 15–28.
37. Cassar S, Teede HJ, Moran LJ et al. Polycystic ovary syndrome and anti-Mullerian hormone: role of insulin resistance, androgens, obesity and gonadotrophins. Clin Endocrinol (Oxf) 2014; 81 (6): 899–906.
38. Fonseca HP, Brondi RS, Piovesan FX et al. Anti-Mullerian hormone and insulin resistance in polycystic ovary syndrome. Gynecol Endocrinol 2014; 30 (9): 667–70.
39. Nardo LG, Yates AP, Roberts SA et al. The relationships between AMH, androgens, insulin resistance and basal ovarian follicular status in nonobesesubfertile women with and without polycystic ovary syndrome. Hum Reprod 2009; 24: 2917–23.
40. Skałba P, Cygal A, Madej P et al. Is the plasma anti-Mullerian hormone (AMH) level associated with body weight and metabolic, and hormonal disturbances in women with and without polycystic ovary syndrome? Eur J Obstet Gynecol Reprod Biol 2011; 158 (2): 254–9.
41. Caglar GS, Kahyaoglu I, Pabuccu R et al. Anti-Mullerian hormone and insulin resistance in classic phenotype lean PCOS. Arch Gynecol Obstet 2013; 288 (4): 905–10.
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56. Birch Petersen K, Pedersen NG, Pedersen AT et al. Mono-ovulation in women with polycystic ovary syndrome: a clinical review on ovulation induction. Reprod Biomed Online 2016; 32 (6): 563–83.
57. Abu Hashim H, Foda O, Ghayaty E. Combined metformin-clomiphene in clomiphene-resistant polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Acta Obstet Gynecol Scand 2015; 94 (9): 921–30.
58. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod 2008; 23 (3): 462–77.
59. Palomba S. Aromatase inhibitors for ovulation induction. J Clin Endocrinol Metab 2015; 100 (5): 1742–7.
60. Ecklund LC, Usadi RS. Endocrine and reproductive effects of polycystic ovarian syndrome. Obstet Gynecol Clin North Am 2015; 42 (1): 55–65.
61. Deveci CD, Demir B, Sengul O et al. Clomiphene citrate ‘stair-step’ protocol vs. traditional protocol in patients with polycystic ovary syndrome: a randomized controlled trial. Arch Gynecol Obstet 2015; 291 (1): 179–84.
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2. Ünlütürk U, Sezgin E, Yildiz BO. Evolutionary determinants of polycystic ovary syndrome–part 1. 2016. Fertil Steril 2016; 106 (1): 33–41.
3. Lauritsen MP, Bentzen JG, Pinborg A et al. The prevalence of polycystic ovary in a normal population according to the Rotterdam criteria versus revised criteria including anti-Mullerian hormone. Hum Reprod 2014; 29 (4): 791–80.
4. El Hayek S, Bitar L, Hamdar LH et al. Poly cystic ovarian syndrome: an updated overview. Front Physiol 2016; 7: 124.
5. Bhide P, Homburg R. Anti Mullerian hormone and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2016. Accepted Manuscript.
6. De Leo V, Musacchio MC, Cappelli V et al. Genetic, hormonal and metabolic aspects of PCOS: an update. Reprod Biol Endocrinol 2016; 14 (1): 38.
7. Maliqueo M, Lara HE, Sánchez F et al. Placental steroidogenesis in pregnant women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2013; 166 (2): 151–5.
8. Jones ME, Boon WC, McInnes K et al. Recognizing rare disorders: aromatase deficiency. Nat Clin Pract Endocrinol Metab 2007; 3 (5): 414–21.
9. Hertig A, Liere P, Chabbert-Buffet N et al. Steroid profiling in preeclamptic women: evidence for aromatase deficiency. Am J Obstet Gynecol 2010; 203 (5): 477.e1–9.
10. Jobe SO, Tyler CT, Magness RR. Aberrant synthesis, metabolism, and plasma accumulation of circulating estrogens and estrogen metabolites in preeclampsia implications for vascular dysfunction. Hypertension 2013; 61 (2): 480–7.
11. Legro RS, Kunselman AR, Demers L et al. Elevated dehydroepiandrosterone sulfate levels as the reproductive phenotype in the brothers of women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002; 87 (5): 2134–8.
12. Sam S, Sung YA, Legro RS, Dunaif A. Evidence for pancreatic beta-cell dysfunction in brothers of women with polycystic ovary syndrome. Metabolism 2008; 57 (1): 84–9.
13. Jones MR, Goodarzi MO. An update on the genetics of polycystic ovary syndrome: progress and future directions. Fertil Steril 2016. Article in press.
14. Cui L, Li G, Zhong W et al. Polycystic ovary syndrome susceptibility single nucleotide polymorphisms in women with a single PCOS clinical feature. Hum Reprod 2015; 30 (3): 732–6.
15. Nandi A, Chen Z, Patel R, Poretsky L. Polycystic ovary syndrome. Endocrinol Metab Clin North Am 2014; 43 (1): 123–47.
16. Dewailly D. Diagnostic criteria for PCOS: need for a rethink? Best Pract Res Clin Obstet Gynaecol 2016. pii: S1521-6934(16)30008-6.
17. Trikudanathan S. Polycystic ovarian syndrome. Med Clin North Am 2015; 99 (1): 221–35.
18. Brassard M, Ain Melk Y, Baillargeon JP. Basic infertility including polycystic ovary syndrome. Med Clin North Am 2008; 92 (5): 1163–92, xi.
19. Azziz R, Carmina E, Dewailly D et al. Task force on the phenotype of the polycystic ovary syndrome of the Androgen Excess and PCOS Society: the Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril 2009; 91 (2): 456–88.
20. Bremer AA, Miller WL. The serine phosphorylation hypothesis of polycystic ovary syndrome: a unifying mechanism of hyperandrogenemia and insulin resistance. Fertil Steril 2008; 89 (5): 1039–48.
21. Baillargeon JP, Nestler JE, Ostlund RE et al. Greek hyperinsulinemic women, with or without polycystic ovary syndrome, display altered inositol metabolism. Hum Reprod 2008; 23 (6): 1439–46.
22. Bevilacqua A, Carlomagno G, Gerli S et al. Results from the international consensus conference on myo-inositol and D-chiro-inositol in obstetrics and gynecology–assisted reproduction technology. Gynecol Endocrinol 2015; 31 (6): 441–6.
23. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999; 84 (1): 165–9.
24. Lerchbaum E, Schwetz V, Giuliani A et al. Assessment of glucose metabolism in polycystic ovary syndrome: HbAc or fasting glucose compared with the oral glucose tolerance test as a screening method. Hum Reprod 2013; 28: 2537–44.
25. Carmina E, Oberfield SE, Lobo RA. The diagnosis of polycystic ovary syndrome in adolescents. Am J Obstet Gynecol 2010; 203 (3): 201.e1–5.
26. Conway GS, Dewailly D, Diamanti-Kandarakis E et al. European survey of diagnosis and management of the polycystic ovary syndrome: results of the ESE PCOS Special Interest Group's Questionnaire. Eur J Endocrinol 2014; 171 (4): 489–98.
27. Liodromiti S, Kelsey TW, Anderson RA, Nelson SM. Can anti-Mullerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and meta-analysis of extracted data. J Clin Endocrinol Metab 2013; 98 (8): 3332–40.
28. Pellatt L, Hanna L, Brincat M et al. Granulosa cell production of anti-Mullerian hormone is increased in polycystic ovaries. J Clin Endocrinol Metab 2007; 92 (1): 240–5.
29. Gassner D, Jung R. First fully automated immunoassay for anti-Mullerian hormone. Clin Chem Lab Med 2014; 52 (8): 1143–52.
30. Beckman Coulter. Access AMH Instructions for Use, September 2014. REFB13127.
31. Nelson SM, Pastuszek E, Kloss G et al. Two new automated, compared with two enzyme-linked immunosorbent, antimüllerian hormone assays. Fertil Steril 2015; 104 (4): 1016–1021.e6.
32. Piouka A, Farmakiotis D, Katsikis I et al. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab 2009; 296 (2): E238–43.
33. Catteau-Jonard S, Bancquart J, Poncelet E et al. Polycystic ovaries at ultrasound: normal variant or silent polycystic ovary syndrome? Ultrasound Obstet Gynecol 2012; 40 (2): 223–9.
34. Pellatt L, Rice S, Mason HD. Anti-Mullerian hormone and polycystic uovary syndrome: a mountain too high? Reproduction 2010; 139 (5): 825–33.
35. Pierre A, Peigné M, Grynberg M et al. Loss of LH-induced down-regulation of anti-Mullerian hormone receptor expression may contribute to anovulation in women with polycystic ovary syndrome. Hum Reprod 2013; 28 (3): 762–9.
36. Garg D, Tal R. The role of AMH in the pathophysiology of polycystic ovarian syndrome. Reprod Biomed Online 2016; 33 (1): 15–28.
37. Cassar S, Teede HJ, Moran LJ et al. Polycystic ovary syndrome and anti-Mullerian hormone: role of insulin resistance, androgens, obesity and gonadotrophins. Clin Endocrinol (Oxf) 2014; 81 (6): 899–906.
38. Fonseca HP, Brondi RS, Piovesan FX et al. Anti-Mullerian hormone and insulin resistance in polycystic ovary syndrome. Gynecol Endocrinol 2014; 30 (9): 667–70.
39. Nardo LG, Yates AP, Roberts SA et al. The relationships between AMH, androgens, insulin resistance and basal ovarian follicular status in nonobesesubfertile women with and without polycystic ovary syndrome. Hum Reprod 2009; 24: 2917–23.
40. Skałba P, Cygal A, Madej P et al. Is the plasma anti-Mullerian hormone (AMH) level associated with body weight and metabolic, and hormonal disturbances in women with and without polycystic ovary syndrome? Eur J Obstet Gynecol Reprod Biol 2011; 158 (2): 254–9.
41. Caglar GS, Kahyaoglu I, Pabuccu R et al. Anti-Mullerian hormone and insulin resistance in classic phenotype lean PCOS. Arch Gynecol Obstet 2013; 288 (4): 905–10.
42. Mahran A, Abdelmeged A, El-Adawy AR et al. The predictive value of circulating anti-Mullerian hormone in women with polycystic ovarian syndrome receiving clomiphene citrate: a prospective observational study. J Clin Endocrinol Metab 2013; 98 (10): 4170–5.
43. El-Halawaty S, Rizk A, Kamal M et al. Clinical significance of serum concentration of anti-Mullerian hormone in obese women with polycystic ovary syndrome. Reprod Biomed Online 2007; 15 (5): 495–9.
44. Vaiarelli A, Drakopoulos P, Blockeel C et al. Limited ability of circulating anti-Mü̈llerian hormone to predict dominant follicular recruitment in PCOS women treated with clomiphene citrate: a comparison of two different assays. Gynecol Endocrinol 2016; 32 (3): 227–30.
45. Irani M, Seifer DB, Grazi RV et al. Vitamin D supplementation decreases TGF-beta1 bioavailability in PCOS: a randomized placebo-controlled trial. J Clin Endocrinol Metab 2015; 100 (11): 4307–14.
46. Pinola P, Piltonen TT, Puurunen J et al. Androgen Profile Through Life in Women With Polycystic Ovary Syndrome: A Nordic Multicenter Collaboration Study. J Clin Endocrinol Metab 2015; 100 (9): 3400–7.
47. Daan NM, Louwers YV, Koster MP et al. Cardiovascular and metabolic profiles amongst different polycystic ovary syndrome phenotypes: who is really at risk? Fertil Steril 2014; 102 (5): 1444–51.e3.
48. Legro RS, Arslanian SA, Ehrmann DA et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2013; 98 (12): 4565–92.
49. Fruzzetti F, Campagna AM, Perini D, Carmina E. Ovarian volume in normal and hyperandrogenic adolescent women. Fertil Steril 2015; 104 (1): 196–9.
50. Lizneva D, Suturina L, Walker W et al. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril 2016; 106 (1): 6–15.
51. Hart R, Doherty DA. The potential implications of a PCOS diagnosis on a woman’s long-term health using data linkage. J Clin Endocrinol Metab 2015; 100 (3): 911–9.
52. Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev 2011; 7: CD007506.
53. Guzick DS. Ovulation induction management of PCOS. Clin Obstet Gynecol 2007; 50 (1): 255–67.
54. Fauser BC, Tarlatzis BC, Rebar RW et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012; 97 (1): 28–38.e25.
55. Spritzer PM, Motta AB, Sir-Petermann T, Diamanti-Kandarakis E. Novel strategies in the management of polycystic ovary syndrome. Minerva Endocrinol 2015; 40 (3): 195–212.
56. Birch Petersen K, Pedersen NG, Pedersen AT et al. Mono-ovulation in women with polycystic ovary syndrome: a clinical review on ovulation induction. Reprod Biomed Online 2016; 32 (6): 563–83.
57. Abu Hashim H, Foda O, Ghayaty E. Combined metformin-clomiphene in clomiphene-resistant polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Acta Obstet Gynecol Scand 2015; 94 (9): 921–30.
58. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod 2008; 23 (3): 462–77.
59. Palomba S. Aromatase inhibitors for ovulation induction. J Clin Endocrinol Metab 2015; 100 (5): 1742–7.
60. Ecklund LC, Usadi RS. Endocrine and reproductive effects of polycystic ovarian syndrome. Obstet Gynecol Clin North Am 2015; 42 (1): 55–65.
61. Deveci CD, Demir B, Sengul O et al. Clomiphene citrate ‘stair-step’ protocol vs. traditional protocol in patients with polycystic ovary syndrome: a randomized controlled trial. Arch Gynecol Obstet 2015; 291 (1): 179–84.
62. Li RH, Ng EH. Management of anovulatory infertility. Best Pract Res Clin Obstet Gynaecol 2012; 26 (6): 757–68.
63. Abu Hashim H. Predictors of success of laparoscopic ovarian drilling in women with polycystic ovary syndrome: an evidence-based approach. Arch Gynecol Obstet 2015; 291 (1): 11–8.
64. Legro RS, Brzyski RG, Diamond MP et al. Letrozole versus clomiphene for infertility in the polycystic ovary syndrome. N Engl J Med 2014; 371 (2): 119–29.
65. Palomba S, de Wilde MA, Falbo A et al. Pregnancy complications in women with polycystic ovary syndrome. Hum Reprod Update 2015; 21 (5): 575–92.
66. Palomba S, Falbo A, Chiossi G et al. Early trophoblast invasion and placentation in women with different PCOS phenotypes. Reprod Biomed Online 2014; 29 (3): 370–81.
67. Koster MP, de Wilde MA, Veltman-Verhulst SM et al. Placental characteristics in women with polycystic ovary syndrome. Hum Reprod 2015; 30 (12): 2829–37.
68. Вarry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 2014; 20 (5): 748–58.
69. Gottschau M, Kjaer SK, Jensen A et al. Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study. Gynecol Oncol 2015; 136 (1): 99–103.
70. Wang Z, Li T, Zhang W et al. Variants in DENND1A and LHCGR are associated with endometrioid adenocarcinoma. Gynecol Oncol 2012; 127 (2): 403–5.
71. Misso M, Boyle J, Norman R, Teede H. Development of evidenced- based guidelines for PCOS and implications for community health. Semin Reprod Med 2014; 32 (3): 230–40.
72. Yildiz BO. Assessment, diagnosis and treatment of a patient with hirsutism. Nat Clin Pract Endocrinol Metab 2008; 4 (5): 294–300.
73. Yildiz BO. Approach to the patient: contraception in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2015; 100 (3): 794–802.
74. Instruktsiia po primeneniiu preparata Modell'' Trend. [in Russian]
75. Instruktsiia po primeneniiu preparata Modell' P'iur. [in Russian]
2. Ünlütürk U, Sezgin E, Yildiz BO. Evolutionary determinants of polycystic ovary syndrome–part 1. 2016. Fertil Steril 2016; 106 (1): 33–41.
3. Lauritsen MP, Bentzen JG, Pinborg A et al. The prevalence of polycystic ovary in a normal population according to the Rotterdam criteria versus revised criteria including anti-Mullerian hormone. Hum Reprod 2014; 29 (4): 791–80.
4. El Hayek S, Bitar L, Hamdar LH et al. Poly cystic ovarian syndrome: an updated overview. Front Physiol 2016; 7: 124.
5. Bhide P, Homburg R. Anti Mullerian hormone and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2016. Accepted Manuscript.
6. De Leo V, Musacchio MC, Cappelli V et al. Genetic, hormonal and metabolic aspects of PCOS: an update. Reprod Biol Endocrinol 2016; 14 (1): 38.
7. Maliqueo M, Lara HE, Sánchez F et al. Placental steroidogenesis in pregnant women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2013; 166 (2): 151–5.
8. Jones ME, Boon WC, McInnes K et al. Recognizing rare disorders: aromatase deficiency. Nat Clin Pract Endocrinol Metab 2007; 3 (5): 414–21.
9. Hertig A, Liere P, Chabbert-Buffet N et al. Steroid profiling in preeclamptic women: evidence for aromatase deficiency. Am J Obstet Gynecol 2010; 203 (5): 477.e1–9.
10. Jobe SO, Tyler CT, Magness RR. Aberrant synthesis, metabolism, and plasma accumulation of circulating estrogens and estrogen metabolites in preeclampsia implications for vascular dysfunction. Hypertension 2013; 61 (2): 480–7.
11. Legro RS, Kunselman AR, Demers L et al. Elevated dehydroepiandrosterone sulfate levels as the reproductive phenotype in the brothers of women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002; 87 (5): 2134–8.
12. Sam S, Sung YA, Legro RS, Dunaif A. Evidence for pancreatic beta-cell dysfunction in brothers of women with polycystic ovary syndrome. Metabolism 2008; 57 (1): 84–9.
13. Jones MR, Goodarzi MO. An update on the genetics of polycystic ovary syndrome: progress and future directions. Fertil Steril 2016. Article in press.
14. Cui L, Li G, Zhong W et al. Polycystic ovary syndrome susceptibility single nucleotide polymorphisms in women with a single PCOS clinical feature. Hum Reprod 2015; 30 (3): 732–6.
15. Nandi A, Chen Z, Patel R, Poretsky L. Polycystic ovary syndrome. Endocrinol Metab Clin North Am 2014; 43 (1): 123–47.
16. Dewailly D. Diagnostic criteria for PCOS: need for a rethink? Best Pract Res Clin Obstet Gynaecol 2016. pii: S1521-6934(16)30008-6.
17. Trikudanathan S. Polycystic ovarian syndrome. Med Clin North Am 2015; 99 (1): 221–35.
18. Brassard M, Ain Melk Y, Baillargeon JP. Basic infertility including polycystic ovary syndrome. Med Clin North Am 2008; 92 (5): 1163–92, xi.
19. Azziz R, Carmina E, Dewailly D et al. Task force on the phenotype of the polycystic ovary syndrome of the Androgen Excess and PCOS Society: the Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril 2009; 91 (2): 456–88.
20. Bremer AA, Miller WL. The serine phosphorylation hypothesis of polycystic ovary syndrome: a unifying mechanism of hyperandrogenemia and insulin resistance. Fertil Steril 2008; 89 (5): 1039–48.
21. Baillargeon JP, Nestler JE, Ostlund RE et al. Greek hyperinsulinemic women, with or without polycystic ovary syndrome, display altered inositol metabolism. Hum Reprod 2008; 23 (6): 1439–46.
22. Bevilacqua A, Carlomagno G, Gerli S et al. Results from the international consensus conference on myo-inositol and D-chiro-inositol in obstetrics and gynecology–assisted reproduction technology. Gynecol Endocrinol 2015; 31 (6): 441–6.
23. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999; 84 (1): 165–9.
24. Lerchbaum E, Schwetz V, Giuliani A et al. Assessment of glucose metabolism in polycystic ovary syndrome: HbAc or fasting glucose compared with the oral glucose tolerance test as a screening method. Hum Reprod 2013; 28: 2537–44.
25. Carmina E, Oberfield SE, Lobo RA. The diagnosis of polycystic ovary syndrome in adolescents. Am J Obstet Gynecol 2010; 203 (3): 201.e1–5.
26. Conway GS, Dewailly D, Diamanti-Kandarakis E et al. European survey of diagnosis and management of the polycystic ovary syndrome: results of the ESE PCOS Special Interest Group's Questionnaire. Eur J Endocrinol 2014; 171 (4): 489–98.
27. Liodromiti S, Kelsey TW, Anderson RA, Nelson SM. Can anti-Mullerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and meta-analysis of extracted data. J Clin Endocrinol Metab 2013; 98 (8): 3332–40.
28. Pellatt L, Hanna L, Brincat M et al. Granulosa cell production of anti-Mullerian hormone is increased in polycystic ovaries. J Clin Endocrinol Metab 2007; 92 (1): 240–5.
29. Gassner D, Jung R. First fully automated immunoassay for anti-Mullerian hormone. Clin Chem Lab Med 2014; 52 (8): 1143–52.
30. Beckman Coulter. Access AMH Instructions for Use, September 2014. REFB13127.
31. Nelson SM, Pastuszek E, Kloss G et al. Two new automated, compared with two enzyme-linked immunosorbent, antimüllerian hormone assays. Fertil Steril 2015; 104 (4): 1016–1021.e6.
32. Piouka A, Farmakiotis D, Katsikis I et al. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab 2009; 296 (2): E238–43.
33. Catteau-Jonard S, Bancquart J, Poncelet E et al. Polycystic ovaries at ultrasound: normal variant or silent polycystic ovary syndrome? Ultrasound Obstet Gynecol 2012; 40 (2): 223–9.
34. Pellatt L, Rice S, Mason HD. Anti-Mullerian hormone and polycystic uovary syndrome: a mountain too high? Reproduction 2010; 139 (5): 825–33.
35. Pierre A, Peigné M, Grynberg M et al. Loss of LH-induced down-regulation of anti-Mullerian hormone receptor expression may contribute to anovulation in women with polycystic ovary syndrome. Hum Reprod 2013; 28 (3): 762–9.
36. Garg D, Tal R. The role of AMH in the pathophysiology of polycystic ovarian syndrome. Reprod Biomed Online 2016; 33 (1): 15–28.
37. Cassar S, Teede HJ, Moran LJ et al. Polycystic ovary syndrome and anti-Mullerian hormone: role of insulin resistance, androgens, obesity and gonadotrophins. Clin Endocrinol (Oxf) 2014; 81 (6): 899–906.
38. Fonseca HP, Brondi RS, Piovesan FX et al. Anti-Mullerian hormone and insulin resistance in polycystic ovary syndrome. Gynecol Endocrinol 2014; 30 (9): 667–70.
39. Nardo LG, Yates AP, Roberts SA et al. The relationships between AMH, androgens, insulin resistance and basal ovarian follicular status in nonobesesubfertile women with and without polycystic ovary syndrome. Hum Reprod 2009; 24: 2917–23.
40. Skałba P, Cygal A, Madej P et al. Is the plasma anti-Mullerian hormone (AMH) level associated with body weight and metabolic, and hormonal disturbances in women with and without polycystic ovary syndrome? Eur J Obstet Gynecol Reprod Biol 2011; 158 (2): 254–9.
41. Caglar GS, Kahyaoglu I, Pabuccu R et al. Anti-Mullerian hormone and insulin resistance in classic phenotype lean PCOS. Arch Gynecol Obstet 2013; 288 (4): 905–10.
42. Mahran A, Abdelmeged A, El-Adawy AR et al. The predictive value of circulating anti-Mullerian hormone in women with polycystic ovarian syndrome receiving clomiphene citrate: a prospective observational study. J Clin Endocrinol Metab 2013; 98 (10): 4170–5.
43. El-Halawaty S, Rizk A, Kamal M et al. Clinical significance of serum concentration of anti-Mullerian hormone in obese women with polycystic ovary syndrome. Reprod Biomed Online 2007; 15 (5): 495–9.
44. Vaiarelli A, Drakopoulos P, Blockeel C et al. Limited ability of circulating anti-Mü̈llerian hormone to predict dominant follicular recruitment in PCOS women treated with clomiphene citrate: a comparison of two different assays. Gynecol Endocrinol 2016; 32 (3): 227–30.
45. Irani M, Seifer DB, Grazi RV et al. Vitamin D supplementation decreases TGF-beta1 bioavailability in PCOS: a randomized placebo-controlled trial. J Clin Endocrinol Metab 2015; 100 (11): 4307–14.
46. Pinola P, Piltonen TT, Puurunen J et al. Androgen Profile Through Life in Women With Polycystic Ovary Syndrome: A Nordic Multicenter Collaboration Study. J Clin Endocrinol Metab 2015; 100 (9): 3400–7.
47. Daan NM, Louwers YV, Koster MP et al. Cardiovascular and metabolic profiles amongst different polycystic ovary syndrome phenotypes: who is really at risk? Fertil Steril 2014; 102 (5): 1444–51.e3.
48. Legro RS, Arslanian SA, Ehrmann DA et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2013; 98 (12): 4565–92.
49. Fruzzetti F, Campagna AM, Perini D, Carmina E. Ovarian volume in normal and hyperandrogenic adolescent women. Fertil Steril 2015; 104 (1): 196–9.
50. Lizneva D, Suturina L, Walker W et al. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril 2016; 106 (1): 6–15.
51. Hart R, Doherty DA. The potential implications of a PCOS diagnosis on a woman’s long-term health using data linkage. J Clin Endocrinol Metab 2015; 100 (3): 911–9.
52. Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev 2011; 7: CD007506.
53. Guzick DS. Ovulation induction management of PCOS. Clin Obstet Gynecol 2007; 50 (1): 255–67.
54. Fauser BC, Tarlatzis BC, Rebar RW et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012; 97 (1): 28–38.e25.
55. Spritzer PM, Motta AB, Sir-Petermann T, Diamanti-Kandarakis E. Novel strategies in the management of polycystic ovary syndrome. Minerva Endocrinol 2015; 40 (3): 195–212.
56. Birch Petersen K, Pedersen NG, Pedersen AT et al. Mono-ovulation in women with polycystic ovary syndrome: a clinical review on ovulation induction. Reprod Biomed Online 2016; 32 (6): 563–83.
57. Abu Hashim H, Foda O, Ghayaty E. Combined metformin-clomiphene in clomiphene-resistant polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Acta Obstet Gynecol Scand 2015; 94 (9): 921–30.
58. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod 2008; 23 (3): 462–77.
59. Palomba S. Aromatase inhibitors for ovulation induction. J Clin Endocrinol Metab 2015; 100 (5): 1742–7.
60. Ecklund LC, Usadi RS. Endocrine and reproductive effects of polycystic ovarian syndrome. Obstet Gynecol Clin North Am 2015; 42 (1): 55–65.
61. Deveci CD, Demir B, Sengul O et al. Clomiphene citrate ‘stair-step’ protocol vs. traditional protocol in patients with polycystic ovary syndrome: a randomized controlled trial. Arch Gynecol Obstet 2015; 291 (1): 179–84.
62. Li RH, Ng EH. Management of anovulatory infertility. Best Pract Res Clin Obstet Gynaecol 2012; 26 (6): 757–68.
63. Abu Hashim H. Predictors of success of laparoscopic ovarian drilling in women with polycystic ovary syndrome: an evidence-based approach. Arch Gynecol Obstet 2015; 291 (1): 11–8.
64. Legro RS, Brzyski RG, Diamond MP et al. Letrozole versus clomiphene for infertility in the polycystic ovary syndrome. N Engl J Med 2014; 371 (2): 119–29.
65. Palomba S, de Wilde MA, Falbo A et al. Pregnancy complications in women with polycystic ovary syndrome. Hum Reprod Update 2015; 21 (5): 575–92.
66. Palomba S, Falbo A, Chiossi G et al. Early trophoblast invasion and placentation in women with different PCOS phenotypes. Reprod Biomed Online 2014; 29 (3): 370–81.
67. Koster MP, de Wilde MA, Veltman-Verhulst SM et al. Placental characteristics in women with polycystic ovary syndrome. Hum Reprod 2015; 30 (12): 2829–37.
68. Вarry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 2014; 20 (5): 748–58.
69. Gottschau M, Kjaer SK, Jensen A et al. Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study. Gynecol Oncol 2015; 136 (1): 99–103.
70. Wang Z, Li T, Zhang W et al. Variants in DENND1A and LHCGR are associated with endometrioid adenocarcinoma. Gynecol Oncol 2012; 127 (2): 403–5.
71. Misso M, Boyle J, Norman R, Teede H. Development of evidenced- based guidelines for PCOS and implications for community health. Semin Reprod Med 2014; 32 (3): 230–40.
72. Yildiz BO. Assessment, diagnosis and treatment of a patient with hirsutism. Nat Clin Pract Endocrinol Metab 2008; 4 (5): 294–300.
73. Yildiz BO. Approach to the patient: contraception in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2015; 100 (3): 794–802.
74. Инструкция по применению препарата Модэлль Тренд. / Instruktsiia po primeneniiu preparata Modell'' Trend. [in Russian]
75. Инструкция по применению препарата Модэлль Пьюр. / Instruktsiia po primeneniiu preparata Modell' P'iur. [in Russian]
________________________________________________
2. Ünlütürk U, Sezgin E, Yildiz BO. Evolutionary determinants of polycystic ovary syndrome–part 1. 2016. Fertil Steril 2016; 106 (1): 33–41.
3. Lauritsen MP, Bentzen JG, Pinborg A et al. The prevalence of polycystic ovary in a normal population according to the Rotterdam criteria versus revised criteria including anti-Mullerian hormone. Hum Reprod 2014; 29 (4): 791–80.
4. El Hayek S, Bitar L, Hamdar LH et al. Poly cystic ovarian syndrome: an updated overview. Front Physiol 2016; 7: 124.
5. Bhide P, Homburg R. Anti Mullerian hormone and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2016. Accepted Manuscript.
6. De Leo V, Musacchio MC, Cappelli V et al. Genetic, hormonal and metabolic aspects of PCOS: an update. Reprod Biol Endocrinol 2016; 14 (1): 38.
7. Maliqueo M, Lara HE, Sánchez F et al. Placental steroidogenesis in pregnant women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2013; 166 (2): 151–5.
8. Jones ME, Boon WC, McInnes K et al. Recognizing rare disorders: aromatase deficiency. Nat Clin Pract Endocrinol Metab 2007; 3 (5): 414–21.
9. Hertig A, Liere P, Chabbert-Buffet N et al. Steroid profiling in preeclamptic women: evidence for aromatase deficiency. Am J Obstet Gynecol 2010; 203 (5): 477.e1–9.
10. Jobe SO, Tyler CT, Magness RR. Aberrant synthesis, metabolism, and plasma accumulation of circulating estrogens and estrogen metabolites in preeclampsia implications for vascular dysfunction. Hypertension 2013; 61 (2): 480–7.
11. Legro RS, Kunselman AR, Demers L et al. Elevated dehydroepiandrosterone sulfate levels as the reproductive phenotype in the brothers of women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002; 87 (5): 2134–8.
12. Sam S, Sung YA, Legro RS, Dunaif A. Evidence for pancreatic beta-cell dysfunction in brothers of women with polycystic ovary syndrome. Metabolism 2008; 57 (1): 84–9.
13. Jones MR, Goodarzi MO. An update on the genetics of polycystic ovary syndrome: progress and future directions. Fertil Steril 2016. Article in press.
14. Cui L, Li G, Zhong W et al. Polycystic ovary syndrome susceptibility single nucleotide polymorphisms in women with a single PCOS clinical feature. Hum Reprod 2015; 30 (3): 732–6.
15. Nandi A, Chen Z, Patel R, Poretsky L. Polycystic ovary syndrome. Endocrinol Metab Clin North Am 2014; 43 (1): 123–47.
16. Dewailly D. Diagnostic criteria for PCOS: need for a rethink? Best Pract Res Clin Obstet Gynaecol 2016. pii: S1521-6934(16)30008-6.
17. Trikudanathan S. Polycystic ovarian syndrome. Med Clin North Am 2015; 99 (1): 221–35.
18. Brassard M, Ain Melk Y, Baillargeon JP. Basic infertility including polycystic ovary syndrome. Med Clin North Am 2008; 92 (5): 1163–92, xi.
19. Azziz R, Carmina E, Dewailly D et al. Task force on the phenotype of the polycystic ovary syndrome of the Androgen Excess and PCOS Society: the Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril 2009; 91 (2): 456–88.
20. Bremer AA, Miller WL. The serine phosphorylation hypothesis of polycystic ovary syndrome: a unifying mechanism of hyperandrogenemia and insulin resistance. Fertil Steril 2008; 89 (5): 1039–48.
21. Baillargeon JP, Nestler JE, Ostlund RE et al. Greek hyperinsulinemic women, with or without polycystic ovary syndrome, display altered inositol metabolism. Hum Reprod 2008; 23 (6): 1439–46.
22. Bevilacqua A, Carlomagno G, Gerli S et al. Results from the international consensus conference on myo-inositol and D-chiro-inositol in obstetrics and gynecology–assisted reproduction technology. Gynecol Endocrinol 2015; 31 (6): 441–6.
23. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999; 84 (1): 165–9.
24. Lerchbaum E, Schwetz V, Giuliani A et al. Assessment of glucose metabolism in polycystic ovary syndrome: HbAc or fasting glucose compared with the oral glucose tolerance test as a screening method. Hum Reprod 2013; 28: 2537–44.
25. Carmina E, Oberfield SE, Lobo RA. The diagnosis of polycystic ovary syndrome in adolescents. Am J Obstet Gynecol 2010; 203 (3): 201.e1–5.
26. Conway GS, Dewailly D, Diamanti-Kandarakis E et al. European survey of diagnosis and management of the polycystic ovary syndrome: results of the ESE PCOS Special Interest Group's Questionnaire. Eur J Endocrinol 2014; 171 (4): 489–98.
27. Liodromiti S, Kelsey TW, Anderson RA, Nelson SM. Can anti-Mullerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and meta-analysis of extracted data. J Clin Endocrinol Metab 2013; 98 (8): 3332–40.
28. Pellatt L, Hanna L, Brincat M et al. Granulosa cell production of anti-Mullerian hormone is increased in polycystic ovaries. J Clin Endocrinol Metab 2007; 92 (1): 240–5.
29. Gassner D, Jung R. First fully automated immunoassay for anti-Mullerian hormone. Clin Chem Lab Med 2014; 52 (8): 1143–52.
30. Beckman Coulter. Access AMH Instructions for Use, September 2014. REFB13127.
31. Nelson SM, Pastuszek E, Kloss G et al. Two new automated, compared with two enzyme-linked immunosorbent, antimüllerian hormone assays. Fertil Steril 2015; 104 (4): 1016–1021.e6.
32. Piouka A, Farmakiotis D, Katsikis I et al. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab 2009; 296 (2): E238–43.
33. Catteau-Jonard S, Bancquart J, Poncelet E et al. Polycystic ovaries at ultrasound: normal variant or silent polycystic ovary syndrome? Ultrasound Obstet Gynecol 2012; 40 (2): 223–9.
34. Pellatt L, Rice S, Mason HD. Anti-Mullerian hormone and polycystic uovary syndrome: a mountain too high? Reproduction 2010; 139 (5): 825–33.
35. Pierre A, Peigné M, Grynberg M et al. Loss of LH-induced down-regulation of anti-Mullerian hormone receptor expression may contribute to anovulation in women with polycystic ovary syndrome. Hum Reprod 2013; 28 (3): 762–9.
36. Garg D, Tal R. The role of AMH in the pathophysiology of polycystic ovarian syndrome. Reprod Biomed Online 2016; 33 (1): 15–28.
37. Cassar S, Teede HJ, Moran LJ et al. Polycystic ovary syndrome and anti-Mullerian hormone: role of insulin resistance, androgens, obesity and gonadotrophins. Clin Endocrinol (Oxf) 2014; 81 (6): 899–906.
38. Fonseca HP, Brondi RS, Piovesan FX et al. Anti-Mullerian hormone and insulin resistance in polycystic ovary syndrome. Gynecol Endocrinol 2014; 30 (9): 667–70.
39. Nardo LG, Yates AP, Roberts SA et al. The relationships between AMH, androgens, insulin resistance and basal ovarian follicular status in nonobesesubfertile women with and without polycystic ovary syndrome. Hum Reprod 2009; 24: 2917–23.
40. Skałba P, Cygal A, Madej P et al. Is the plasma anti-Mullerian hormone (AMH) level associated with body weight and metabolic, and hormonal disturbances in women with and without polycystic ovary syndrome? Eur J Obstet Gynecol Reprod Biol 2011; 158 (2): 254–9.
41. Caglar GS, Kahyaoglu I, Pabuccu R et al. Anti-Mullerian hormone and insulin resistance in classic phenotype lean PCOS. Arch Gynecol Obstet 2013; 288 (4): 905–10.
42. Mahran A, Abdelmeged A, El-Adawy AR et al. The predictive value of circulating anti-Mullerian hormone in women with polycystic ovarian syndrome receiving clomiphene citrate: a prospective observational study. J Clin Endocrinol Metab 2013; 98 (10): 4170–5.
43. El-Halawaty S, Rizk A, Kamal M et al. Clinical significance of serum concentration of anti-Mullerian hormone in obese women with polycystic ovary syndrome. Reprod Biomed Online 2007; 15 (5): 495–9.
44. Vaiarelli A, Drakopoulos P, Blockeel C et al. Limited ability of circulating anti-Mü̈llerian hormone to predict dominant follicular recruitment in PCOS women treated with clomiphene citrate: a comparison of two different assays. Gynecol Endocrinol 2016; 32 (3): 227–30.
45. Irani M, Seifer DB, Grazi RV et al. Vitamin D supplementation decreases TGF-beta1 bioavailability in PCOS: a randomized placebo-controlled trial. J Clin Endocrinol Metab 2015; 100 (11): 4307–14.
46. Pinola P, Piltonen TT, Puurunen J et al. Androgen Profile Through Life in Women With Polycystic Ovary Syndrome: A Nordic Multicenter Collaboration Study. J Clin Endocrinol Metab 2015; 100 (9): 3400–7.
47. Daan NM, Louwers YV, Koster MP et al. Cardiovascular and metabolic profiles amongst different polycystic ovary syndrome phenotypes: who is really at risk? Fertil Steril 2014; 102 (5): 1444–51.e3.
48. Legro RS, Arslanian SA, Ehrmann DA et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2013; 98 (12): 4565–92.
49. Fruzzetti F, Campagna AM, Perini D, Carmina E. Ovarian volume in normal and hyperandrogenic adolescent women. Fertil Steril 2015; 104 (1): 196–9.
50. Lizneva D, Suturina L, Walker W et al. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril 2016; 106 (1): 6–15.
51. Hart R, Doherty DA. The potential implications of a PCOS diagnosis on a woman’s long-term health using data linkage. J Clin Endocrinol Metab 2015; 100 (3): 911–9.
52. Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev 2011; 7: CD007506.
53. Guzick DS. Ovulation induction management of PCOS. Clin Obstet Gynecol 2007; 50 (1): 255–67.
54. Fauser BC, Tarlatzis BC, Rebar RW et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012; 97 (1): 28–38.e25.
55. Spritzer PM, Motta AB, Sir-Petermann T, Diamanti-Kandarakis E. Novel strategies in the management of polycystic ovary syndrome. Minerva Endocrinol 2015; 40 (3): 195–212.
56. Birch Petersen K, Pedersen NG, Pedersen AT et al. Mono-ovulation in women with polycystic ovary syndrome: a clinical review on ovulation induction. Reprod Biomed Online 2016; 32 (6): 563–83.
57. Abu Hashim H, Foda O, Ghayaty E. Combined metformin-clomiphene in clomiphene-resistant polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Acta Obstet Gynecol Scand 2015; 94 (9): 921–30.
58. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod 2008; 23 (3): 462–77.
59. Palomba S. Aromatase inhibitors for ovulation induction. J Clin Endocrinol Metab 2015; 100 (5): 1742–7.
60. Ecklund LC, Usadi RS. Endocrine and reproductive effects of polycystic ovarian syndrome. Obstet Gynecol Clin North Am 2015; 42 (1): 55–65.
61. Deveci CD, Demir B, Sengul O et al. Clomiphene citrate ‘stair-step’ protocol vs. traditional protocol in patients with polycystic ovary syndrome: a randomized controlled trial. Arch Gynecol Obstet 2015; 291 (1): 179–84.
62. Li RH, Ng EH. Management of anovulatory infertility. Best Pract Res Clin Obstet Gynaecol 2012; 26 (6): 757–68.
63. Abu Hashim H. Predictors of success of laparoscopic ovarian drilling in women with polycystic ovary syndrome: an evidence-based approach. Arch Gynecol Obstet 2015; 291 (1): 11–8.
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74. Instruktsiia po primeneniiu preparata Modell'' Trend. [in Russian]
75. Instruktsiia po primeneniiu preparata Modell' P'iur. [in Russian]
Авторы
С.О.Дубровина*
1. ФГБОУ ВО Ростовский государственный медицинский университет Минздрава России. 344022, Россия, Ростов-на-Дону, пер. Нахичеванский, д. 29;
2. ФГБУ Ростовский НИИ акушерства и педиатрии Минздрава России. 344012, Россия, Ростов-на-Дону, ул. Мечникова, д. 43
*s.dubrovina@gmail.com
1. Rostov State Medical University of the Ministry of Health of the Russian Federation. 344022, Russian Federation, Rostov-on-Don, per. Nakhichevanskii, d. 29;
2. Rostov Research Institute of Obstetrics and Pediatrics of the Ministry of Health of the Russian Federation. 344012, Russian Federation, Rostov-on-Don, ul. Mechnikova, d. 43
*s.dubrovina@gmail.com
1. ФГБОУ ВО Ростовский государственный медицинский университет Минздрава России. 344022, Россия, Ростов-на-Дону, пер. Нахичеванский, д. 29;
2. ФГБУ Ростовский НИИ акушерства и педиатрии Минздрава России. 344012, Россия, Ростов-на-Дону, ул. Мечникова, д. 43
*s.dubrovina@gmail.com
________________________________________________
1. Rostov State Medical University of the Ministry of Health of the Russian Federation. 344022, Russian Federation, Rostov-on-Don, per. Nakhichevanskii, d. 29;
2. Rostov Research Institute of Obstetrics and Pediatrics of the Ministry of Health of the Russian Federation. 344012, Russian Federation, Rostov-on-Don, ul. Mechnikova, d. 43
*s.dubrovina@gmail.com
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